Lecture Note: Ayurvedic Management of Psychiatric Disorders (Part-1)

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Ayurvedic Management of Psychiatric Disorders
Part-1

Prof. Muralidhara Sharma

Transcript by
Dr. Swati Sharma
Senior resident, Dept of Kriya Sharir, IMS BHU
and Dr. Varsha More

based on the lecture available at-Ayurvedic Management of Psychiatric Disorders

I will be dealing with the issue only from the point of view of a general Ayurvedic practitioner and the practical issues that come across in the routine clinical practice related to psychiatry. There are certain important issues which are basic and introductory. The first of the question is what is mind?  From Ayurvedic point of view, mind or Mannas is well defined. Mannas is a dravya, which means it has a function as well as a guna or property.  So, anything which has both guna (property) and Karma (function) is a Dravya. Charak has said,

खादीन्यात्मा मनः कालो दिशश्च द्रव्यसङ्ग्रहः | सेन्द्रियं चेतनं द्रव्यं, निरिन्द्रियमचेतनम्|| Ch. Su 1/48

It is one of means of dealing with or connecting with Atma to produce the knowledge.  This is the Indian Philosophical concept for attaining Gyan (knowledge). Atma’ Manasand Indriya these have-to-have Sannikarsha with Artha (the objects that are perceived through any of the sensory organs). So, it is one of the mediators of the sensations to the Atma.  Whereas the contemporary science, the existence of the mind is not clear. It is defined in various forms and it’s considered something very vague and subtle. It has been defined as something which is responsible for once thoughts and feelings. And it’s also the seat of the ‘Faculty of Reason’ and the aspect of interact. But these are not really clearly defined. It also related to perception, memory, emotion and so on. Whereas from Ayurvedic point of view, these functions are well defined. The function of Atma and function of Manna are well defined and they’re better understood in Ayurveda. From the Contemporary, one of the important issues from the point of psychiatry and psychiatry related to medicines. Majority of the Pharmacological entities related to mind are supposed to relate to the brain. There are many studies that where the functions of mind they are related to the biochemical changes seen in brain and hence the general physiological aspects of mind related, willing to do something to the brain. The question is whether it’s really the brain which matters about mind or there is something more than that.

From Ayurvedic point of view Hridya is the Chetana sthana.  Hridya is considered as the Chtena sthana. Heart is the chetna sthana whereas according to majority of the physiologist now, brain is the seat of mind. But still even in the contemporary science there are a good number of people who differ from the popular concept of brain being the seat of mind rather there are people or there are many observations that are done to prove that heart is the area where emotions are located.  Now I put a few of those views and the others of different views on both the phase. Some people articles or the textual supports, which suggest the brain is the physical place where mind resides and the literary support to suggest the other way that heart is the master and brain is the servant. This kind of controversies exist and there is a lot of confusion among the contemporary scientists.

A Survey of Psychiatrist’s perception regarding the concept of ‘Mind’ and its position in psychiatry today Shrirang Bakhle1 1Consultant Psychiatrist – Private Practice and Independent Researcher, Mumbai

I have just presented a result of a survey conducted among the psychiatrist practioner in India, and the results of the survey about the opinion about the mind among the practitioner’s practicing psychiatry where 70% of the people they say that psychiatry is concerned to mind, but none of them could give brain as the seat of mind with the definite asset. 80.5% felt that mental denoted the mind whereas, a large number of people believe that there is some entity called mind but it cannot be just identified. So, it is considered to be something different from the brain. Weather it is brain or mind that has be considered, there is a lot of difference of opinion. But there is one breakthrough in the contemporary science John Andrew Armour, and he is the one who has established an anatomical entity, which is also considered as the heart brain. And he has written a monograph on that with all his research studies where he has proved that there is neurological system a complex neurological nervous system and he has named it as cardiac nervous system. This system comprised of a large number of neurons and its relationship with the mind and the emotions.  The emotions being related to the heart that is the basic idea of this new concept. Or rather it’s a new concept as such. So, in general we consider that heart is the seat of emotions.

Mental health care act

“A substantial disorder of thinking, mood and perception, orientation, or memory that grossly impairs judgment, behavior, capacity to recognize reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs. But it doesn’t regard mental retardation, a condition of arrested or incomplete development of mind of a person, specially characterized by sub normality of intelligence, as mental illness”

 The clinical practice related to psychiatry is regulated by Mental Health Act 2017 which was passed through. A mental illness in the act is defined as substantial disorder of thinking, mood and perception, orientation, or memory and it grossly impairs judgment, behavior, and capacity to recognize, reality or ability to meet the ordinary demands of life. So certain of those conditions which we other ways considers a psychiatric illness may not be considered a mental illness as long as they do not affect the day today activity of the person. So mental conditions associated with the abuse of alcohol as well as drugs are also included under mental illness. But it doesn’t regard a mental retardation as a condition as such so. So mental retardation is not a psychiatric illness. Congenital or developmental errors are not considered as mental illness. This is the very important issue which we have to be very clear cut about that because of the existing laws.

Highlights of new major Mental health care act

 Of course, the major highlights of new major Mental health care act which was passed in 2017, gives certain issues; where a patient has a right to access mental health care and insurance cover etc. But we will not go into those details. Some of the important points are, Suicide is not considered as a crime. Before 2017, an attempt to suicide was considered to be a crime and it has to be adjudicated under criminal act. Whereas with, the current law it’s not so.

Mental health professional

Then some more of the issues related to the clinical practice in the Mental healthcare Act would be, the mental health professionals according to the law is a psychiatrist as defined as, a professional who is registered with the state authority. There is a need to register yourself as a mental or psychiatric practitioner for practicing or dealing with psychiatric conditions. So, if you are treating a psychiatric illness are mental illness, it is mandatory that there should be a registration in the specific board for some state set up. And of course, a person with post graduate degree in Ayurveda Mano rog Vigyan Avum Manas roga is considered as a professional psychiatric doctor. Similar amendments were done for Homeopathy, Siddha Unanai and other traditional knowledge systems.

“Clinical psychologist” means a person––

(i) having a recognized qualification in Clinical Psychology from an institution approved and recognized, by the Rehabilitation Council of India, constituted under section 3 of the Rehabilitation Council of India Act, 1992; or

 (ii) having a Post-Graduate degree in Psychology or Clinical Psychology or Applied Psychology and a Master of Philosophy in Clinical Psychology or Medical and Social Psychology obtained after completion of a full time course of two years which includes supervised clinical training from any University recognised by the University Grants Commission established under the University Grants Commission Act, 1956 and approved and recognised by the Rehabilitation Council of India Act, 1992 or such recognised qualifications as may be prescribed;

As per the Council Indian Consular Act of 1992, no another important issue related to the mental health can act places the mental health establishments. Like if you’re running a hospital it has to be registered so mental health establishment they need to research in central or state mental health authority has to be established, and it has to be registered and state mental party is to be established, which is having the responsibility of registering and appointing nominated, and so on. So there has to be a separate set up. So, a simple medical practitioners may not present as a mental health specialist.  My purpose is just to sensitize that the health camps practicing psychiatric conditions are regulated by the separate law and we need to be aware of the existing law.

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